Autologous hematopoietic stem cell transplantation in refractory rheumatoid arthritis: Sustained response in two of four patients

Burt, Richard K.; Georganas, Constantinos; Schroeder, J.; Traynor, Ann E.; Stefka, Jakub; Schuening, Friedrich; Graziano, Frank M.; Mineishi, Shin; Brush, Mary; Fishman, M.; Welles, Colleen; Rosen, Steven T.; Pope, Richard M.

doi:10.1002/1529-0131(199911)42:11<2281::aid-anr4>3.0.co;2-e

Cited by 74 publications

(45 citation statements)

References 16 publications

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“…Although these studies demonstrated good initial response to therapy, they also showed that CR is unusual and serologic or clinical relapse between 12 and 24 months is common. [11][12][13][14] Since the early reports on long-term remissions of RA involved transplantation of allogeneic stem cells, several authors have postulated a graft-versus-autoimmunity effect (GvA) similar to the wellknown-graft-versus-leukemia (GvL) effect in hematological malignancies. [5][6][7] With the recent development of dosereduced conditioning regimens, the issue of allogeneic transplantation in RA became the subject of scientific discussions.…”

Section: Discussionmentioning

confidence: 99%

Early recurrence of rheumatoid arthritis after nonmyeloablative allogeneic blood stem cell transplantation in a patient with multiple myeloma

Tapprich

Fenk

Schneider

et al. 2003

Bone Marrow Transplant

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Summary:Allogeneic blood stem cell transplantation with reduced conditioning has been proposed as a new, potentially curative treatment option for patients with rheumatoid arthritis (RA). We report a 60-year-old woman with RA and coexisting multiple myeloma who was treated with high-dose melphalan and autologous blood stem cell transplantation (BSCT) followed by a nonmyeloablative allogeneic BSCT from her healthy dizygotic twin brother. She achieved a complete remission of her RA after autologous BSCT, but relapsed early despite complete donor chimerism following successful allogeneic transplantation with reduced intensity conditioning. This case illustrates that allogeneic BSCT following nonmyeloablative conditioning may be an uncertain option for curing patients with RA.

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Section: Discussionmentioning

confidence: 99%

Early recurrence of rheumatoid arthritis after nonmyeloablative allogeneic blood stem cell transplantation in a patient with multiple myeloma

Tapprich

Fenk

Schneider

et al. 2003

Bone Marrow Transplant

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“…9 In Chicago, four patients with RA have been treated with cyclophosphamide 200 mg/kg, ATG 90 mg/kg, methylprednisolone 3 g followed by a CD34 + cell enriched (2.5-2.7 log T-cell depleted) autograft. 16 Two of the four patients in this trial demonstrated sustained ACR 70 responses, whereas the remaining two were less successful. Likewise two patients in Omaha had ACR 70 responses until 6 months when disease recurrence occurred.…”

Section: Pilot Studiesmentioning

confidence: 85%

Hematopoietic stem cell transplantation for severe rheumatoid arthritis

Moore

Snowden

Pavletić

et al. 2003

Bone Marrow Transplant

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Summary:The substantial morbidity and mortality associated with rheumatoid arthritis (RA), while not widely appreciated, provide adequate justification for consideration of highdose immunoablative therapy followed by hematopoietic stem cell transplantation. While some patients with RA follow a benign course, selected subsets of patients have been identified with 5-year survival rates of 40-70%. A number of factors that can be easily determined serve as useful prognostic indicators for poor outcome. These include the presence of many involved joints (total joint count), the degree of functional disability as measured by the health assessment questionnaire and the presence of rheumatoid factor. This article summarises the present status of hematopoietic stem cell transplantation for rheumatoid arthritis and proposes future directions for research.

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“…Following HCT, there was a somewhat better response to DMARDs supporting the immunomodulating effect of HCT. There has been variable success of HCT in RA, but the results have not been encouraging as compared to diseases like SSc or MS [87][88][89].…”

Section: Hct In Rheumatoid Arthritis and Juvenile Idiopathic Arthritismentioning

confidence: 99%

Hematopoietic Cell Transplantation for Autoimmune Diseases: A Review of History, Current State, and Future Issues

Resnick¹,

Metodiev²,

Lazarova³

2017

Immunotherapy - Myths, Reality, Ideas, Future

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Autoimmune diseases are characterized by recurrent attacks and remissions, but as a rule they progress and eventually cause a severe disability and death. The present chapter contains general characteristics of autoimmune disease pathogenesis, ways to cause immune tolerance by hematopoietic cell transplantation (HCT), clinical aspects of the treatment for established autoimmune diseases with a special attention to multiple sclerosis (MS) and systemic sclerosis (SSc). A profound analysis of authors' point of view and of the available literature has been performed. The promising results allows to consider HCT as a relevant treatment option for a certain autoimmune diseases.

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Autologous hematopoietic stem cell transplantation in refractory rheumatoid arthritis: Sustained response in two of four patients

Cited by 74 publications

References 16 publications

Early recurrence of rheumatoid arthritis after nonmyeloablative allogeneic blood stem cell transplantation in a patient with multiple myeloma

Early recurrence of rheumatoid arthritis after nonmyeloablative allogeneic blood stem cell transplantation in a patient with multiple myeloma

Hematopoietic stem cell transplantation for severe rheumatoid arthritis

Hematopoietic Cell Transplantation for Autoimmune Diseases: A Review of History, Current State, and Future Issues

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